Many children in England and Wales are heading back to school next week. Schools have already reopened in Scotland and Northern Ireland.
There are lingering doubts among parents about the danger of coronavirus infection, despite evidence that children are at lower risk of serious illness and death.
This week a major new study has added to our knowledge of Covid-19 outcomes in children. The authors say it should reassure parents. Let’s take a look.
The British Medical Journal has just published a large study of people hospitalised with the coronavirus in 260 hospitals in England, Wales and Scotland.
Out of nearly 70,000 people treated in those hospitals between 17 January and 3 July 2020, 651 (just under 1 per cent) were under-19s with confirmed coronavirus.
Of those 651 children and teenagers, 116 needed critical care and six died.
All six deaths were among children and young people with serious underlying health conditions. Three were newborn babies “with severe comorbidities/illness—very premature, complex congenital cardiac anomaly, and bacterial sepsis”.
Three were aged 15 to 18, two with “profound neurodisability with pre-existing respiratory compromise” and a third whose immune system had been suppressed by chemotherapy.
The six deaths were about 1 per cent of all children hospitalised – “strikingly low” compared to a case fatality rate of 27 per cent for people of all ages over the same time period, the authors said.
There were no deaths among previously healthy children.
As with the adult population, black children were over-represented in the cohort of children taken to hospital with coronavirus, and black ethnicity was associated with increased odds of being admitted to critical care.
Also in keeping with the adult population, obese children and those with certain severe underlying illnesses were more likely to need critical care.
But while there are differences in the relative risks for different groups of children, the absolute risk of any child becoming critically ill or dying from Covid-19 remains extremely low. How low?
The Office for National Statistics recorded 11 deaths of children of children and teenagers aged 19 and under due to Covid-19 in England and Wales from March to June this year. We don’t know how many had underlying conditions.
There are around 14 million people of that age in England and Wales, which suggests the chance of any child or teen catching Covid-19 and dying from it are currently more remote than one in a million.
Some 52 children in the study were identified as having symptoms used by the World Health Organization to identify MIS-C, an inflammatory syndrome doctors first identified in April.
This worrying syndrome can see children develop symptoms in many different parts of the body. Thankfully, cases are rare and there were no deaths among the children diagnosed with MIS-C in this study.
What about the risk to adults?
All of this fits what we previously knew about Covid from evidence collected in the UK and around the world: children are likely to have a mild or asymptomatic form of the illness, and are much less likely to become seriously ill and die.
But questions remain about how likely children are to infect others with the virus, even if they are not showing any symptoms.
A Public Health England report published last week showed that outbreaks of coronavirus in schools have been rare so far, and that staff members were more likely to have infected each other than to have caught the disease from children.
Pupils were more likely to have picked up the infection at home, from a parent, than from classmates.
The European Centre for Disease Prevention and Control says: “Currently available evidence indicates that children are not the primary drivers of SARS-CoV-2 transmission to adults in the school setting.”